Okamoto N, Suzuki A, Ohnishi M, Fukuda M
Department of Ophthalmology, NTT West Osaka Hospital, 2-6-40 Karagatuji, Tennoji-ku, Osaka 543-0042, Japan.
Nippon Ganka Gakkai Zasshi. 2001 Mar;105(3):193-5.
Formation of collateral pathways by veins on the optic nerve head is sometimes observed during the resolution of a central retinal vein occlusion (CRVO). However, no cases have been reported which documented the formation and involution of these collateral pathways during the resolution of a CRVO.
A 56-year-old man with a non-ischemic CRVO was followed over a 10-year period by ophthalmoscopy, fluorescein angiography (FA), and indocyanine green angiography (IA). Initial examination revealed only mild arteriosclerosis and absence of the optociliary vein (OCV) in the right eye. Approximately 9 years later, the patient returned with non-ishemic CRVO, and FA demonstrated a prolongation of the retinal circulation time to 12.1 seconds (normal < 11.0 seconds). Monitoring of this patient during treatment disclosed development of an OCV on the optic nerve head and gradual decrease in the retinal hemorrhage. In FA, the retinal circulation time was shortened and returned to normal. IA verified an outflow through the OCV into choroidal veins. Later, ophthalmoscopy showed a narrowing of the diameter of the OCV.
We suggest that the OCV developed to drain blood from retinal veins to the vortex veins through choroidal veins to compensate for the slowing of retinal blood outflow. The reperfusion of the central retinal vein was accompanied by the narrowing of the OCV.
在视网膜中央静脉阻塞（CRVO）消退过程中，有时可观察到视神经乳头处静脉形成侧支循环通路。然而，尚无报道记录CRVO消退过程中这些侧支循环通路的形成及消退情况。
一名56岁非缺血性CRVO男性患者，通过检眼镜检查、荧光素血管造影（FA）和吲哚菁绿血管造影（IA）随访10年。初始检查仅发现右眼轻度动脉硬化且无睫状视网膜静脉（OCV）。约9年后，患者因非缺血性CRVO复诊，FA显示视网膜循环时间延长至12.1秒（正常<11.0秒）。该患者治疗期间的监测发现视神经乳头处出现一条OCV，视网膜出血逐渐减少。在FA检查中，视网膜循环时间缩短并恢复正常。IA证实有血液通过OCV流入脉络膜静脉。后来，检眼镜检查显示OCV直径变窄。
我们认为，OCV的形成是为了将视网膜静脉血液通过脉络膜静脉引流至涡静脉，以补偿视网膜血液流出减慢。视网膜中央静脉再灌注伴随着OCV变窄。
